PROJECT SUMMARY Candidate: I am Assistant Professor of Pediatric Infectious Diseases at Virginia Commonwealth University (VCU), which has a research-intensive school of medicine. I have conducted research under my mentor Dr. William Petri for 4 years and have 10 publications, 4 as first author. I have presented at the last 3 annual meetings of the American Society of Tropical Medicine and Hygiene and have secured research funding from the VCU Children's Hospital Foundation, the Bill and Melinda Gates Foundation, and Pantheryx, Inc. Career Development Plan/Career Goals & Objectives: It is my goal to become an independently funded clinical researcher with expertise in designing and conducting trials to understand and mitigate the effect of infectious diseases on child health in low-income settings. To this end, I will take several classes in clinical research design and implementation. I have an advisory committee of successfully funded researchers with similar interests to my own that have proven track records in mentoring young scientists. Research Plan: The work proposed in this K23 award will take place utilizing two existing cohort studies currently being conducted by my mentor, Dr. Petri, and our collaborators in Bangladesh. Specific Aim 1: Test if a positive GHBT in infancy is predictive of future stunting and neurodevelopmental deficits in Bangladeshi children. Plan: Using an ongoing birth cohort, I will measure GHBT at four time points in the first two years of life and test for an association with anthropometric outcomes and the Bayley Scales of Infant and Toddler Development. Specific Aim 2: Define the structure and function of the duodenal microbiome associated with GHBT. Additionally, test if the duodenal microbiome correlates with the fecal microbiome in GHBT positive infants. Plan: We will perform 16S rDNA V4 sequencing on duodenal and fecal samples from Bangladeshi children with and without a positive GHBT. In a subset, we will also perform metagenomic sequencing to investigate how this dysbiosis affects the metabolic function of the enteric microbiome, focusing on hydrogen production and consumption. Mentor/Co-Mentor(s), and Collaborator(s): The primary mentor of this K23, Dr. William Petri, has a 30-year record of NIH Funding and excellent mentorship. My advisory committee and collaborators include experts in microbiome studies, enteric pathogens, malnutrition, environmental enteropathy, and pediatric investigation. Environment and Institutional Commitment to the Candidate: I have access to fantastic resources at VCU, the University of Virginia, and The International Centre for Diarrhoeal Disease Research, Bangladesh. I have a strong commitment from my department and division assuring 75% protected research time and support of my continued mentorship under Dr. Petri at the University of Virginia. Further, the Dean of Research at the VCU School of Medicine sits on my advisory committee demonstrating phenomenal institutional support.